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Published on: February 26, 2013
Population Attributable Risks of Potential Modifiable Factors for Atrial Fibrillation in China: A National Survey
Zhiqiang Nie1,2, Hongbin Xu2, Chen Chen3
1Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, People's Republic of China.
Insights
Over half of atrial fibrillation (AF) cases in China are preventable. Addressing modifiable risk factors like hypertension can significantly reduce the AF burden and improve public health outcomes.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Atrial fibrillation (AF) is linked to increased mortality and reduced mobility.
- The preventable burden of AF in China due to modifiable risk factors remains unclear.
Purpose of the Study:
- To determine the proportion of AF burden in China attributable to modifiable risk factors.
- To identify key modifiable risk factors for AF in the Chinese adult population.
Main Methods:
- A cross-sectional study of 726,451 adults aged ≥40 years in China.
- Identified seven modifiable risk factors: BMI, smoking, alcohol, physical inactivity, hypertension, diabetes, dyslipidemia.
- Calculated population-attributable risks (PARs) using odds ratios (ORs).
Main Results:
- The overall prevalence of AF was 2.6% (18,736 cases).
- Hypertension, diabetes, and dyslipidemia showed the highest adjusted odds ratios for AF.
- Nearly 60% of AF cases were attributable to the seven modifiable risk factors.
Conclusions:
- Hypertension is the primary preventable risk factor for AF in China.
- More than half of all AF cases in China could potentially be prevented by managing modifiable risk factors.
Background:
There is an association between atrial fibrillation (AF) and overall mortality as well as mobility. It is not known, however, what the preventable burden of AF in China is. This study aims to identify what proportion of the burden of AF may be avoided by modifiable risk factors.
Methods:
As part of the China National Stroke Screening and Prevention Project, 726,451 adults aged ≥40 years were enrolled in a representative cross-sectional study. The following seven factors have been categorized as modifiable risk factors for AF: body mass index, smoking, alcohol consumption, physical inactivity, hypertension, diabetes mellitus, and dyslipidemia. In order to calculate population-attributable risks (PARs), odds ratios (ORs) were calculated for selected risk factors.
Results:
The crude ORs increased with age (ORs ranged from 1.92 to 4.02). A total of 18,736 cases of prevalent AF have been identified. The overall prevalence of AF was 2.6%. The crude ORs increased with age (ORs range 1.92-4.03). The adjusted ORs and the corresponding confidence intervals (CIs) for these seven modifiable factors were 1.16 (95% confidence interval [CI]: 1.12-1.19), 1.56 (95% CI: 1.49-1.62), 2.15 (95% CI: 2.02-2.28), 2.07 (95% CI: 2.01-2.14), 2.71 (95% CI: 2.62-2.79), 2.10 (95% CI: 2.02-2.19), 2.52 (95% CI: 2.44-2.60), and 3.32 (95% CI: 3.18-3.48), respectively. Accordingly, 59.3% of all cases of AF could be explained by having these modifiable risk factors, among which hypertension accounted for the greatest share.
Conclusion:
In China, hypertension is the leading preventable cause of AF, and more than half of these cases can be prevented through improving those modifiable risk factors.
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